- Molina Healthcare (Aurora, IL)
- …license. + OR Bachelor's or master's degree in gerontology, public health, or social work with related case management experience. **Required Experience** 3 ... the site of service. **KNOWLEDGE/SKILLS/ABILITIES** Oversees an integrated Care Management team responsible for case management...with their healthcare needs. Care Management staff work to help members achieve optimal clinical ,… more
- WellSense (Manchester, NH)
- …community based organizations/partners o resolve complex issues related to the medical and social case management of members. Acts as a liaison to the Legal ... manager will oversee the training of the staff and work collaboratively with the clinical trainer to...state licensure as a Registered Nurse . Certification in Case Management Preferred **Competencies, Skills, and Attributes:**… more
- Actalent (Santa Barbara, CA)
- …perform utilization management activities, which can encompass telephonic or onsite clinical reviews, case or disease management , care coordination or ... Health Services policies and procedures. + Stay current with clinical knowledge related to disease processes. + Effectively communicate,... Management team consists of two other Case Managers and two administrative staff. The work… more
- Rush University Medical Center (Chicago, IL)
- …on the circumstances of each case . **Summary:** The Manager of Social Work Care Management has specialized knowledge, education, and experience in the fields ... Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Ambulatory Care Management ** Work Type:** Full Time (Total FTE between 0.9 and… more
- CommonSpirit Health (Englewood, CO)
- …is a remote position** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews referred by case management staff and/or ... utilization of health care services. This individual meets with case management and health care team members...staff + Provides feedback and education to the Care Management and Clinical Documentation Departments through written… more
- AmeriHealth Caritas (Charleston, SC)
- … clinical practice experience in medical and behavioral health + 1+ years of case management experience in a clinical managed care environment required, ... **Role Overview** Under the supervision of the Director Clinical Market Population Health, the Manager of Integrated...Plans, organizes and directs the development and implementation of Case Management operations.; Ensures staff is properly… more
- Elevance Health (Wallingford, CT)
- …may be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina Medicaid. May be responsible for ... **Utilization Management Medical Director- NC Medicaid** Location: This role...with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians… more
- Ventura County (Ventura, CA)
- …advanced journey clinical level assigned more leadership responsibilities and complex clinical and case management responsibilities. A PSW III requires ... immediate (I) or general (II, III, IV) supervision, provides clinical or administrative psychiatric social work services...accept clinical leadership responsibilities, the most complex clinical and case management responsibilities,… more
- Sumitomo Pharma (Helena, MT)
- …marketed products. + Conduct safety surveillance over product life cycle, reviewing clinical trial and post-marketing Individual Case Safety Reports (ICSRs), ... on behalf of PVRM for: Study Protocols, Informed Consent Forms (ICF), Safety Management Plans (SMP), Clinical Study Reports (CSR), Investigator's Brochures (IB),… more
- MetroHealth (Brooklyn Heights, OH)
- …Science in Nursing. Valid Ohio RN licensure. Three to Five years of case management or managed care experience. Ability to work independently and as a member ... team in the provision of patient care. Performs a clinical review of selected patients to determine service needs....obtains within 12 months of hire. Preferred: Master's Degree. Case Management Certification. Experience with case… more